Regular readers know that I spent countless hours last summer tracking down the requested average 2016 rate change filing forms for every single state in the country, and then compiling them into my best guesstimate about the overall, weighted average rate changes for the individual policy market in each state and nationally.

In the end, I came up with a national projected weighted average increase of 12-13%, although I also made sure to note that I expected the effective average to only be around 9% after the dust settled...due to people shopping around.

As it happens, I turned out to be pretty much dead on target: The "presumptive" average (ie, assuming every single enrollee stayed with the same policy whenever possible) ended up being 11.6% nationally, while the effective average ended up being 8%.

Avik Roy is a well-known conservative, anti-ACA healthcare pundit, writer and advisor. As the article I link to below describes him:

Avik Roy is a Republican’s Republican. A health care wonk and editor at Forbes, he has worked for three Republican presidential hopefuls — Mitt Romney, Rick Perry, and Marco Rubio. Much of his adult life has been dedicated to advancing the Republican Party and conservative ideals.

Regular readers know that he and I have butted heads several times in the past:

Just a little while ago I reminded folks about's OFF-exchange Plan Finder, which very few people seem to be familiar with.

Just moments ago, the CMS division of HHS announced a complete overhaul/update to their already-existing searchable Hospital Compare database, which appears to be basically a Yelp for hospitals. From today's CMS blog post:

This is a quick be honest, it's mainly here just to remind myself to refer to the link again for a later project. But I just wanted to remind everyone that in addition to the exchange-based Qualified Health Plan listings at HealthCare.Gov (which cover 38 states) and the rate review database where you can search through the proposed (and, eventually, approved) rate hikes for every ACA-compliant individual or small group policy by carrier, there's also a third database: The Plan Finder.

Welcome to Plan Finder

This Plan Finder website is provided by the federal government to help you find private health plans available outside the Health Insurance Marketplace. We want you to find health insurance that best fits your budget and meets your needs.

Sara Hansard of Bloomberg News reports on an interesting tidbit for #OE4:

Getting subsidies for Affordable Care Act health plans is about to become easier.

Additional verification of eligibility will only be required if the difference between stated income and Internal Revenue Service or Social Security data is at least 25 percent, or $6,000, underguidance from the Department of Health and Human Services.

Currently, additional verification is required if the discrepancy is only 10 percent or greater.

The change, which is for the 2017 plan year, “will reduce the number of consumers who have to follow-up and submit documentation to verify their household income while maintaining important program integrity controls,” the Centers for Medicare & Medicaid Services said in the guidance.

I hereby admit that a) I don't know much about Medicare (remember, my major focus is on the ACA exchanges, Medicaid expansion, the individual/small group market and so forth) and b) I'm swamped at the moment so don't have time to do a real analysis/write-up on today's announcement, but it appears to be a Pretty Big Deal, so I'll just present the press release/statement for the moment:

U.S. Department of Health & Human Services • Monday, July 25, 2016 • News Release • 202-690-6343

Important Next Step towards a Better, Smarter, Healthier Medicare:
New Payment Models and Rewards for Better Care at Lower Cost

Today, the Department of Health & Human Services proposed new models that continue the Administration’s progress to shift Medicare payments from quantity to quality by creating strong incentives for hospitals to deliver better care to patients at a lower cost. These models would reward hospitals that work together with physicians and other providers to avoid complications, prevent hospital readmissions, and speed recovery.


CMS approves Arizona’s plan to re-open CHIP program

Today, the Centers for Medicare & Medicaid Services (CMS) announced that it has approved Arizona’s plan to allow new enrollment in the Children’s Health Insurance Program (CHIP) after enrollment was frozen for several years. Now all states provide CHIP coverage to eligible children. 

“Today’s approval is a step forward for the health of Arizona children in low-income families,” said Vikki Wachino, CMS Deputy Administrator and Director of the Center for Medicaid and CHIP Services. “With Arizona’s decision, all states in the nation now provide CHIP coverage to any eligible child who applies. More children in Arizona will have access to coverage early in their lives, which helps kids grow into healthy adults and provides parents with the peace of mind that comes from their children having affordable coverage.”

Having coverage through CHIP improves children’s health and increases their ability to succeed in school. Recent research on Medicaid and CHIP shows that these gains are long lasting, with children who gained coverage experiencing better health, higher educational attainment, and higher earnings as adults.

(Originally Posted 6/09/16)

Every year, Republicans insist that the ACA is guaranteed to cause a rate hike "death spiral" as increasing premiums cause healthier people to drop out of the individual exchange market, causing higher medical expenses, causing even higher premiums, causing more healthy people to drop out and so forth...and every year, for three years in a row so far, this has failed to be the case nationally. While premiums have obviously continued to increase for many people, the individual insurance market has grown each year, from around 11 million in 2013 to 15.6 million in 2014, around 17 million last year and up to 19-20 million or so today.

IMPORTANT: This is really just a placeholder for Georgia's 2017 average rate hike requests, because it's extremely spotty and partial so far. I'll update it once I'm able to actually track down the bulk of Georgia's individual market enrollment and rate hike request numbers.

UPDATE 7/25/16:  I've managed to acquire the additional filings; see update below

Remember the Hobby Lobby and Little Sisters of the Poor Supreme Court cases, in which each protested the ACA's requirement that healthcare plans covered by employers include contraceptive coverage?

Well, guess what? It turns out there's another "Obamacare contraceptive requirement" case which chugging along through the federal court system, and a federal judge just ruled against the government again. This time, however, instead of an employer having a problem with providing contraception for "sincerely felt" religious reasons, it's the enrollee who's getting the vapors over the prospect of being required to receive the coverage.

As reported by the "Religion Clause" blog (h/t to Patrick O'Mahen and Greg Lipper for the heads up):

The Dept. of Justice is suing to block both of the big mega-mergers between Aetna/Humana and Anthem/Cigna.

Meanwhile, Humana just released their quarterly earnings report [correction: their 2017 Earnings Guidance Report]...and there's some big news buried in it.

Thanks to Zach Tracer for the heads up:

Commenter "M E" just asked an important question about the Land of Lincoln debacle:

Likely stupid question here, but if they were doing this bad financially that they couldn't even make it though all of 2016, then how come when requesting their 2016 rates last year they (apparently) asked for less than a 10% bump?

I mentioned this yesterday in my "back from vacation" post, but it's important enough to deserve a separate follow-up post...especially given the clarification about the coverage cut-off date:

Land of Lincoln coverage will end Oct. 1 for individual enrollees

Land of Lincoln Health's insurance coverage for its individual enrollees will end Oct. 1, according to the Illinois Department of Insurance.

The agency posted the news on Land of Lincoln's website. A green banner now greets visitors to the website with the headline, "Important notice to all members" with a link taking them to information about the Chicago-based insurer's impending shutdown. The notice comes a week after the agency moved to seize control of the financially troubled Chicago-based insurer.

Back in early May, Covered California, the largest state-based ACA exchange in the country, issued their proposed 2016-2017 budget, which included this tidbit:

California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases.

The projected rate increase in California, included in the exchange’s proposed annual budget, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces.

...Insurers in California have submitted initial rates for 2017, but the final figures won’t be known until July after state officials conduct private negotiations.

Last Wednesday, I noted that I was taking off for a week on a family camping vacation, and that...

I'm sure nothing of any significance whatsoever will happen in healthcare news over the next 5 days, right?

I guess I should've known better. Within minutes of my posting that, I saw this...

• New data on insurers' ACA struggles
• Burwell on the law's future
• And much more in our special Obamacare issue:

— Dan Diamond (@ddiamond) July 13, 2016

...which included feature stories about: